Echoes From The Past

 

Life’s Promise

Somehow we have a dream that a stable and glorious future will open before us. It is unlikely. Our lives are not ours alone because we share it with family and intimates, but also must share it with the world at large which is not under our control. But the past has a way of reaching out to us which is not necessarily a bad thing. It may tell us about how the world is and such things as the variability of opportunity. 

From My Past

In 1967 (yikes that’s a long time ago) I took a job in the inner city of Baltimore. I was one of the first people hired in one of the first community mental health programs in the country. I was just leaving Duke with my doctorate in hand and I was definitely ready to depart academia. The whole idea of community mental health was to bring mental health services to the public using a public health model. It was a marvelous idea.

Wait a Minute!

But there was not just one problem. Communities are different, and because of that the whole idea of applying the medical model to our inner lives was flawed and established practice is not so easily changed.

I was given an office and told to give service. But there was no one there except for a woman social worker. She led me out into the city and steadily the staff grew. Young professionals learned about the community and what it needed. It was tumultuous and fascinating.

Wait Another Minute!

But in some ways the least of our problem was adapting services to a poverty environment in chaos. An even larger problem proved to be the conservatism of the mental health establishment. All they wanted was the grant money and the glory of having landed funding for a “glamorous” enterprise. They had been providing services by psychiatric residents and medical students on six week rotations. We dug in our heels. The people of that community needed reliable ongoing services, not a series of inexperienced people passing out medication. Granted, our group of twenty somethings were inexperienced, but we were dedicated as a group to learning fast and meeting real needs. 

What We Concluded

What we found was a need for life management  in a form of partnership. Many “mental health” problems were an outgrowth of the dynamics of the poverty environment more than anything else. Of course, it was much more complicated than that but that is a rough outline. But we had found that a highly beneficial set of services and programs could have been focused.

In the End

At last though, those in power are in power after all. In time the bright eyed, groundbreaking young people moved on and the higher powers invoked a retrenchment. The community based clinics were closed, staff was withdrawn to a central building and business as usual restored.

Across the country the reform movement of that era was coming to an end.  And with its end came the end of community mental health. I tell the whole story in my book Whatever Happened to Community Mental Health.

Now the Lesson

Yes, community mental health came too soon and its time is still not yet at least until we get through our present upheaval when a younger generation with vision may take power.

But, looking back we can see something. On the street we learned a huge amount about such communities, but all the data was kept in our heads and used to formulate a highly focused, problem solving service system. If a system with managers of more vision were to be devised now, the information technology at our fingertips could help us sift, store, integrate and develop data for a viable system. And it could be adapted to fit the community at hand—whatever its form. Then we would truly have a community mental health system, but probably with a more refined name. And if we had had information technology we could have documented and built.

Coming back to one of my original points, I can see that something from the past can be brought forward to a much more adapted use at a future time when new tools and vision are available.

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Don’t Miss My Developing Gaia’s Majesty Trilogy

I refer to it as a work of magical realism. It is a series with a strong mythological element and a real world setting in this time when women are being empowered at last. It is a time of wonder and awakening for all of humankind.

Gaia’s Majesty-Mission Called: Women in Power – Book 1

(Available now in Kindle and paperback on Amazon.) 

Avery had dedicated her life to work for the future of third world women. Her life was enhanced when she met the man who became the love of her life. They could not know that they shared a destiny and that a mission set long ago by our Earth Goddess was to be revealed before them.

Gaia’s Majesty-Challenge: The Chosen Rise – Book 2

(Available now in Pre-Order and goes on sale April 29 on Amazon)

These people, called Tethyans, live in cities in the sea but can morph into fully human form and come to land to form families. They join with the warrior women called the Andromeda to fight against the forces working to impair the future of humankind. Avery has found her birth name of Chantia and she and Beck find there is soon to be a child of seeming great import just as the world falls into terrible strife with millions already dead. 

Our New Age Blossoming – 2

 

 

Looking Back

It is now over 50 years later than when I went to work in Baltimore. For me time offers not perspective as much as confirmation. The only perspective I find is that I can now clearly see the roots of my deep mistrust of the truth and wisdom of older white men. In fairness there is diversity among them but in our present age the fact of their rule is distressing in so many regards.

Designing a Delivery System

The community mental health movement came with a multi-part design. I was stationed in an outpatient facility which meant I was to consult with the community and deliver services. That seems simple enough. Go out and get acquainted so you get referrals and then give therapy with the psychiatrists giving medication as necessary. What fools we mortals be!

What we found immediately was that we had a lot of learning to do. The community was challenging to put it mildly. They were in serious need and mental health services were not at the top of their list.

The Existing System

There already was a mental health system in place. At the hospital nearby people could come for service. Since it was a medical school there were medical students who often were giving service in six week rotations—with little prior experience. Then there were residents. I’ll save you the agony of all the details but they were not acquainted with the needs of the community either and so could not respond effectively.

At the time psychiatric residents were committed to giving intensive psychotherapy. The local residents were not exactly candidates so they often simply got medication. We immediately found a fundamental truth. The biggest enemy of mental health in the area was the stress of poverty. So they suffered from depression and anxiety. Duh!!!

The System We Designed

Each of us took a morning walk-in clinic. We assessed the person’s problems and then spent the afternoon on the phone arranging appropriate services and getting information about availability among a lot of other things. For example, if they had a physically ill child who was not getting service or inappropriate service we sought appropriate help. Every center had a Vocational Rehabilitation Counselor who got a lot of referrals. Very many of these people needed training and/or education. A job or a better job had a very beneficial effect on their mental health along with the experience of hope.

Not So Simple

Did we have the support of higher ups? Sometimes, but often not. The older white men generally wanted to preserve the existing system and were primarily interested in the aura of getting the money for a grant to a new glamorous type of program. They loved the aura and wanted to look good to each other. Daily we were in the position of fending off orientations and demands which did not serve our community well. One of my common responses was “We’ll get back to you” or ”Let me look at alternatives.”

Allies With the Community

We  had to develop relationships with the community so we could respond to their real needs. In that era of the beginning of the civil right movement the community became contentious and interesting. Assertions of community needs and objections to the mistreatment of black men began at that time. There were issues about health services. At one point growing activism led to a difficult public hearing and I found myself sitting next to the state head of the mental health system who was clueless. Other times we were visited by arrogant “consultants” from Washington who we had to endure. 

I’ll leave it there for now. It was rough and tumble and never-ending as we fought for the people of the community. You might think we would have had allies from the professions but they were too often few and far between.

Another Major Wave of Change

In some ways we didn’t understand what we were seeing either. In the end the establishment brought down the community mental health movement. As the young rebels left, the clinics in the community were closed and the old ways resumed. I tell the full story in my book Whatever Happened to Community Mental Health.

But two things came out of the era that proved to have a long wave and import for our future. One was the civil rights movement and in the next post I’ll go into the other one. 

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt